CD 2 (Wednesday 7.20) 2 hour for Ultrasound monitoring appointment and fill out paperwork: 2 tiny follicles on L ovary. Ask nurse if I can get a jump start on paper work for PGS, she tells me no-you can’t do PGS this cycle you are too late.75IU menopur injection PM.

CD 3 (7.21) 75 units Gonal F injection AM, 75IU menopur injection PM

CD 4 (7.22) 75 units Gonal F injection AM, 75IU menopur injection PM

CD 5 (7.23) 75 units Gonal F injection AM, 75IU menopur injection PM

CD 6 (7.24) 75 units Gonal F injection AM, 75IU menopur injection PM

CD 7 (Monday 7.25) 75 units Gonal F injection AM, 1 hr for Bloodwork: E2 240. 1 hr Meeting with Dr. G discuss 5 day transfer, PGS and Gestational Carrier. Told it would be close to impossible to get all of the meetings and paper work done to be cleared to do PGS this cycle, but we are welcome to try. Spend 8 hours making calls/emailing/sitting on hold to secure appointments for PGS clearance and tracking down missing Cetrotide. 75IU menopur injection PM

CD 9 (Wednesday 7.27) 75 units Gonal F injection AM, .25mg Cetrotide Injection AM. 1 hour for Ultrasound 3 follies on L, 3 follies on R, Bloodwork:E2 560. 6 hours of meetings and travel to get to BWH to get approved for PGS. Met with Genetic Counselor in the same waiting room we waited for 2 hours on 12/28/2009 while listening to fetal heart beats echoing through the paper thin walls from the monitored pregnant women in the next area and then sat in the same office that we sat in 12/28/09 to hear that Ava had a Fatal Neural Tube defect and she was non-viable. After suffering a Post Traumatic Stress Induced panic attack (with full head to toe hives and tears)-cleared to do the “impossible” PGS this cycle. Call nurse to tell her we achieved the impossible and to please pass our epic heroic victory on to Dr G so that she can adjust my meds to boost my follicle production.30 minutes of freaking out and emailing when I wake up in middle of night because I realize any PGS screened frozen blasts from this cycle won’t be allowed to be transfer to a Gestational Carrier unless we have the F.D.A approval blood testing done on us before retrieval. Immediately email the nurse and remind her we plan to do PGS and may need a GC in the future and ask why we haven’t had this blood work scheduled yet,to please tell us what it entails and help us get it set up STAT. 75IU menopur injection PM.

CD 10 (Thursday 7.28) 75 units Gonal F injection AM, .25mg Cetrotide Injection AM. 6 hours tracking down the nurse in order to find out why I haven’t heard back from her in regards to the FDA testing. She tells me Dr. G said she will refuse to transfer any frozen material to a GC therefor FDA testing is not necessary. I have a complete fucking melt down and remind nurse that PGS is costing us $3500 out of pocket, and freezing embros will cost us another $2000 out of pocket-and since chances are high that we will have very few normal blasts on ANY cycle with PGS, having a back up of frozen normal blasts that have been FDA approved to transfer to a GC in case we have a lousy fresh cycle that yields 1 or no fresh normals blasts when we have paid 3K out of pocket to prep the GC’s uterus is quite advantageous, so get Dr. G’s sweet little ass back on the horn and tell her we disagree completely with her and schedule us IMMEDIATELY for the FDA testing. Also asked nurse to remind Dr. G we are doing PGS and confirm she doesn’t want to up my meds to produce more follicles as I currently only have 6 measurable follicles when Dr. G said she wants to see 18-20 follicles on a PGS cycle. Nurse tells me Dr G. is happy with my production thus far an no medication adjustments necessary.75IU menopur injection PM.

CD 11 (Friday 7.29) 75 units Gonal F injection AM, .25mg Cetrotide Injection AM, 1 hour for Ultrasound: 3 follies L, 5 follies, Blood work: E2 906. 6 hours to establish we are set to do FDA approval blood draws the morning we go in for the egg retrieval. Get a call from the nurse, looks like I am green aka “ready to retrieve” in the system because too many of my 8 follicles are mature and we are waiting to hear back from Dr. G but most likely we will have to trigger tonight. I have yet another meltdown and call my husband to relay this ridiculous news because 8 follicles is no where near the goal of 20 so I know that no matter what happens in the next 48 hours we have not made enough eggs to even be able to do PGS (which requires 10 embryos on Day 3 which normally takes about 18-20 follicles to yield). Nurse calls back to say no trigger, Dr. G feels that because this is a PGS cycle she wants to grow my follicles a little larger before retrieval. I finally loose my shit and unload a torrent of obscenities on this nurse and tell her she has 5 minutes to call Dr G back and remind her that the PGS lab, the genetics counselor, our research and Dr G herself told us that unless we have 10 FUCKING EMBRYOS GROWING PERFECTLY 3 DAYS AFTER RETRIEVAL THAT DOING PGS WAS A MOTHER LOVING WASTE OF OUR MONEY BECAUSE PGS WEAKENS EVEN PERFECT NORMAL EMBRYOS AND THE CHANCE OF HAVING NOTHING TO TRANSFER IS WAY TOO HIGH we are refusing to do PGS on this cycle as I only have 8 stupid follicles, tell Dr. G that and that we will only agree to a day 5 transfer attempt and don’t care if there is nothing left to transfer-a day 3 transfer at any point will not be tolerated. Nurse calls back 1 hour later and says Dr. G agrees with you on all accounts-I say “You’re welcome.” She then tells me Dr G wants to keep me stimming for 1 more day to proceed at the same medication levels tonight and come back tomorrow morning-we will most likely trigger you tomorrow night. She then proceeds to ask if we still want the FDA approval blood testing done-I remind her that the reason we would need FDA approval would be because we would be doing PGS and potentially freezing material for a GC-so CLEARLY WE WILL NOT NEED TO DO THIS SINCE #1WE AREN’T DOING PGS AND #2 WE WILL BE INSANELY LUCKY TO HAVE ANYTHING TO TRANSFER LET ALONE FREEZE and then hang up the phone on her.75IU menopur injection PM, Dr. Brooke adds an additional injection of 75 units Gonal F PM to hopefully boost the number of mature follicles since Dr G is fucking idiot and can’t be trusted.

CD 12 (Saturday 7.30) Dr Brooke adds 75 units to the prescribed 75 (150 total) units of Gonal F injection AM, .25mg Cetrotide Injection AM, 1 hour for Ultrasound-where I find that my efforts have been rewarded and now have 6 measurable follicles on L, 6 measurable follicles on R, Blood work: E2 1251. First half of this game is complete! Tonight we trigger at 1:30am. Ultrasound images of my ovaries today about 16 hours before trigger shot are below. Have sexy time per doctors orders to ensure we have a nice fresh batch of swimmers to get the job done on Monday. Novarel 10,000 units hcg PM.

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CD 13 (Sunday 7.31) Day off of phone calls/emails/monitoring, injections and all drugs. No food after midnight.

CD 25 (Friday 8.12-6dp5dt) Crinone 8% PM, BA PM, faint-but tweakable BFP on IC strip at 4am. Call nurse and request Beta for 8.13 at 12dpo-request DENIED. Visible line at 11am, Slighter Darker line by 10pm, no need to tweak to see it but BFN on digital. Acupuncture.

Those 4 words are probably the 4 most horrible words I know. This is a field of infertility that is the most “controversial” and the most “experimental” because the vast majority of tests and treatments for those 4 words have all come out within the last 10 years (most within the last 5). They aren’t controversial or experimental because they can’t diagnose issues and they can’t correct issues-they are just new. Because they are newer-every insurance company will refuse to pay for both the diagnostic testing and the treatments for recurrent pregnancy loss leaving the broken infertile couple with only 2 options

1. somehow come up with a LOT of money to pay for everything out of pocket and maybe end up with a healthy take home baby

or

2. decline the testing and continue to use insurance for assisted reproduction until you run out of insurance coverage or you’re beaten into submission and give up because there is something wrong with you that is causing all of these measures to fail.

I have been betrayed by my own body, we have been tried by fire, and a type of hell that so many will never have to face, that just physically and emotionally wears you down so there is nothing left to give to this struggle. One gives up not because they no longer desire to make a child-on a contrary-my desire now is exponentially higher than when we started. It has grown over the years because I know (and see daily) women that become mothers without effort, without thought, without patience or loss and though they are good mothers-I know that I will be better.

I know that I will be better not because I am special, or more worthy or that I have read more books but because I have struggled and toiled in order to make a child. I have longed and waited. I have cried and prayed. I have planned over and over again. It is because of this-like most things in life, the people who truly have appreciation are those who have struggled to attain their dreams.

I have appreciation-that’s for damn sure.

It is the only thing that struggling with forced pregnancy termination and infertility has given me that could possibly count as a *potential* positive. I will notice everything about my child if I ever get one. I will take time and appreciate watching my child sleep, explore, learn, grow and discover and will marvel at this miracle every day for the rest of my life.

I will be happy and appreciate the fact that I can wake in the middle of the night to the sound of my child, knowing that I can comfort, hold and feed them and truly, I mean truly appreciate the fact that I am not waking up with an empty uterus to go to another monitoring appointment, give myself another injection, go through another egg retrieval, pee on another test and cry tears of a broken dream. Because if I ever get to give birth to a live healthy baby

my dream will be crying for me.

Having to make the heartbreaking choice to terminate a non viable pregnancy and then suffer years of infertility treatments and miscarriages has given me this insight. Right now I am counting this special vision as a positive-but recently I have begun to get the sinking feeling that it is only a positive if I am lucky enough to be standing at the end of this journey with a healthy baby in my arms. Otherwise this special insight that I have because of all we have endured, will be by far the most negative part of this battle yet.

A woman should never have to carry around an appreciation like this, for the rest of her life, if it is her destiny to never give birth to a healthy take home baby.

And this weeks winner of the most entertaining phrase typed into a search engine that brought them to my blog is …

“what all can fit up in a uterus?”

I know for sure ultrasound techs like to point out an empty uterus on the screen and tell you “that this is where the baby will be if you get pregnant.” As if we are too stupid to have figured that out and had been storing (or had big plans to store) other things in there instead???

At first I thought perhaps its me-and I look like I’m slow on the uptake-but no, I know of 2 other women who have had an ultrasound tech tell them the same exact thing. One of those women, as soon as the tech informed her of how its *supposed* to be, went home and removed the martini glasses and vodka bottle she had been storing up in her uterus and now has a lovely little baby girl.

This morning at 5:45am while trying to make small talk with one of my former clients from a couple years ago while waiting for my current client to return from getting a sip of water..

me: Lookin good momma!

her: Thanks! Its so hot in here!

me: Yeah I know-its not very conducive to you bun in the oven types so make sure to use the fans and drink lots of water to keep your body temp withing healthy range!

her: Yeah I guess, not much more time to complain about this so I will suck it up!

My client returns who knows of my reproductive woes, he and his wife had reproductive woes that ended with them adopting 3 kids from guatemala after a failed IVF cycle and he knows that I am currently within a week of egg retrieval and of course now has a shocked look on his face as he sees how bubbly and nice I am being to an “effortless breeder…”

Is it too fucking much to ask that your doctor proactively tries to find the best way possible to get you to your goal and making sure that along the journey to the goal that we are crossing off the potential bad things that could be the root of our issues along the way so that at the end of the journey we can look back and say-“yep, we tested for that, and tried that.” Essentially leaving no stone unturned?

The answer is yes.

Yes it is clearly too much to ask. I am fed up with the blank stares, the forgetting, the fumbling, the lack of communication on their parts which ALWAYS leads to crisis and a lot of work on my part and most of all the fact that I am forced to do all of the leg work and research in order to advocate for my own care.

This is what I am paying you for. Not for me to come in ask you questions, and have you stare at me blankly and tell me that you just don’t know. If I am doing all of this-then really what am I paying you for????????

For fuck sake lady c’mon already. Get with the program. I don’t want to ever No one should ever have to sit in an office with a supposed doctor and rage draw a flow chart in order to get a point across. Ever.

Yes-this is the flow chart I drew in front of my doctor-and yes-she looked at me as if I was insane (really, me?? I’m not the supposed doctor here) the entire time I was drawing it and walking her through it.

She again completely denied me a prescription for lovenox, again claimed she had never heard of intralipid infusions to help with immune issues that could be killing my babies in utero-but agreed that PGS could be useful. Mind you she didn’t come up with that on her own!!!

Oh no, why would she???

You merely have a 35 year old healthy patient sitting in front of you that is normal or above average on all accounts who has lost 6 fucking babies -4 of which were before week 5 and the other 2 both measured behind the entire time with one dying at 9 weeks while the other went on to have no brain or skull and be labeled as non viable at 16 weeks.

Clearly there is s.o.m.e.t.h.i.n.g. fucking wrong here, and if you believe so solidly that #1 I don’t have a blood clotting disorder, and that #2 I don’t have immune issues-then all that is left out of the 3 possible things causing the dead baby syndrome is that we make chromosomally abnormal not healthy babies. So if that is all that is left in your humble opinion-then why the FUCK wouldn’t you have said “you know what Brooke-I think we should grow these bad boys out to day 3, take a cell out of what ever is still going and look at them to see if you are making some healthy babies using PGS and then do a day 5 transfer of 2 blasts if you have any that survive because I honestly don’t believe in immune disorders and don’t believe you have a clotting issue so at least this way we can rule out bad babies????”

I am so f’ing busy jumping through hoops and red tape in order to get PGS approved for this cycle it is ridiculous.

In addition to the 2 appointments this am (one for blood work the other to meet with douche canoe) I’ve made no less than 10 phone calls in the last 3 hours, 4 phone calls my husbands made in the last 3 hours to get appointments and find out if PGS is possible for next weeks’ retrieval-I also found out that the hospital FORGOT to fill my prescription for antagon (to prevent my LH surge) which I need to start injecting TOMORROW morning-so now I am scrapping to get that filled and overnighted TOO.

…but it can buy you a gestational carrier with endless attempts to make you a healthy take home baby, and well-that’s kinda the same thing now isn’t it?

This PGS and day 5 transfer business had better work because I picked up the information for the Gestational Carrier program and we don’t have $16,350 to begin to make a move on our back up plan if this fails.

That’s more than I paid for my car.

That’s slightly more than what we just took out of the baby fund-which is now empty after paying out of pocket for all of our diagnostic tests in june and installing a new roof on our home last month-out of necessity as it was raining inside our house.

And that fee-it only covers enrolling a gestational carrier into the program, managing her care while in the program and 1 embryo transfer (not any of the blood tests she or her husband will need, attorney fees to draw up a contract, mandatory counseling fees for no less than 6 sessions, supplemental insurance in case the GC ends up in the emergency room due to some freak mishap during transfer, medication costs to prep her for the transfer and paying her for work she misses to do all of this for us). It could easily be $22K by the time everything is factored in.

And that’s only for 1 transfer with a 45% chance of pregnancy and no guarantee that it will end with a healthy baby.

Fuck me running.

What infertile person who has spent money hand over fist on fertility treatments and surgeries for bad pregnancies has 20K just kicking around??

What, do I just walk into a bank and ask for loan that is comparable to a new auto loan and explain to them its a solid investment as there is only a 55% chance of this woman *literally* flushing the 20K down the toilet at the end of her cycle??

Yes, trust me, I completely understand this is cheaper than adopting.

Yes, trust me, I completely understand this is cheaper than donor eggs.

Yes, trust me, I completely understand that this is better than being childless.

But seriously, when potentially your only option of bring home a baby is fiscally unattainable for 4 years (2-3 if I stop all fertility treatments, and never go on a real vacation while we save up, and pray that nothing else bad happens to our house of doom in the mean time)-it doesn’t give me the feeling of comfort I had hoped.

A lot could happen in that amount of time-especially to our potential GC.

…that make me feel as if I am being suffocated in the large house we purchased over 4 years ago (in the month before everything started to crash-causing an immediate 50% depreciation in our investment that is still worth 50% less even after 4 years), with ample bedrooms for future children and nice big yard for them to play safely in.

Now as I sit here with an insane headache from injecting the byproducts of menopausal women’s urine into me, I feel trapped, claustrophobic, have uber buyers remorse and feel that the entire upstairs is mocking me.

I believe 2 things-first that menopur makes my poor brain just ache, and second-there is no injection easier to prep, administer and handle in my body in this whole IVF process than the Gonal-F pen.

In comparison to the mix and then administer Gonal-F :

and any other injections where you have to reconstitute the product then administer it with a 27 or 25 gauge needle. The gauge of the Gonal-F pen’s, which are 29-and trust me 2 sizes is a world of difference and makes this whole process not nearly as sucky.

I was spoiled.

The very first injection I did was with a Follistim pen, then the Gonal F pens (both 29 gauge needles)-I had no idea why so many women online were complaining about how painful injections were, and showing their stomachs all full of bruises just a few days into the stimming process.

I truly thought they were just bad at adminstering the shot-I had not a single bruise on me after 12 days of injections on my last IVF cycle (which was only Gonal-F).

Now I get it.

Some insurance companies must really suck and not give you the choice, or your RE is a loser and has no idea the huge difference between prescribing the same med only one comes with a thicker gauged needle and the other a tiny one-either way you should know if ever you find yourself going through IVF-request the pens. I suspect if every RE had to physically go through this process themselves, they would never prescribe anything but them!

I inject the menopur with a 27 gauge needle, in comparison to the gonal f pen which is a 29.

The proof is in the pudding (literally my belly is like pudding)-

There are no bruises, or even red dots to point to from the 3 Gonal-F injections I’ve done so far-but three nice sized welts from the menopur.

Dear Baby Jesus,

Please let me grow chromosomally normal eggs exceedingly quickly so that I can stop with this nonsense and move on to jamming estrogen pills and progesterone into my vjay to make me insanely sick for 2 weeks.

Dildo cam this morning showed that my ovaries have close to no activity going on in them whatsoever aside from 2 tiny follicles on the left that were both under 3mm in size, estradiol levels are below 40 and I started spotting yesterday (officially cycle day 1) so I got the call this afternoon to begin the shots that make the eggs.

And of course, it started out with a bang!

First injection, immediate hematoma and blood running down my belly-we’re off to a great start!